Levemir copay assistance card full#

(b) OZEMPIC ® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg: Pay as little as (“PALA”) $25, subject to a maximum savings of $150 per 1-month prescription, $300 per 2-month prescription, or $450 per 3-month prescription, for up to 24 months from the date of Savings Offer activation. (a) FIASP ® (insulin aspart injection) 100 U/mL: Pay as little as (“PALA”) $25 per 30-day, $50 per 60-day, or $75 per 90-day supply for up to 24 months from the date of Savings Offer activation, subject to a maximum savings of $150 per 30-day, $300 per 60-day, or $450 per 90-day supply. This offer is good for eligible patients purchasing up to a 90-day supply. The parties reserve the right to rescind, revoke, or amend this offer without notice at any time. This program is managed by ConnectiveRx on behalf of Novo Nordisk.

It is illegal to (or offer to) sell, purchase, or trade this offer. Patient is responsible for complying with any insurance carrier copayment disclosure requirements, including disclosing any savings received from this program. Novo Nordisk intends that all savings from this offer accrues to the patient. This Savings Offer cannot be combined with any coupon, certificate, voucher, or similar offer. No other purchase is necessary. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. Not valid if reproduced.Ĭash Discount Cards and other non-insurance plans are not valid as primary insurance under this offer. This offer is not transferable and is limited to one offer per person. Availability of the Savings Offer in Massachusetts will be dependent upon state law in effect at the time patient presents the Savings Offer when paying for the covered medications. This offer is valid only in the United States and its territories, unless prohibited by law, and may be redeemed at participating retail pharmacies. Patients with questions about the Savings Offer may call 1-87. Re-confirmation of patient information may be requested periodically to ensure accuracy of data and compliance with terms. Novo Nordisk’s Eligibility and Restrictions, and Offer Details may change from time to time, and for the most recent version, please visit this webpage. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described herein and will not seek reimbursement for any benefit received through this offer. This offer may not be redeemed for cash. This offer is not valid when the entire cost of your prescription drug is eligible to be reimbursed by a commercial insurance plan or other commercial health or pharmacy benefit programs.

Levemir copay assistance card full#

Offer excludes full cash-paying patients. The brand and the prescription being filled must be covered by the patient’s commercial insurance plan.

Patient must be enrolled in a commercial insurance plan. Patient is not eligible if he/she is enrolled in any federal or state health care program with prescription drug coverage, such as Medicaid, Medicare, Medigap, VA, DOD, TRICARE, or any similar federal or state health care program (each a Government Program), or where prohibited by law. A valid Prescriber ID# is required on the prescription. In order to redeem this offer, patient must have a valid prescription for the brand being filled.